r/dysautonomia • u/nyoxin • 20h ago

Support IST advice

21/F. I have been on beta blockers (Bisoprolol) for almost a week which have been amazing for my heart rate and has gone back to normal almost already, the issue is in day 4 I had two episodes of chest pain, palpitations and pre-syncope but also experienced a tight throat feeling. My heart rate stayed normal this time too. I’m wondering if I have the right diagnosis as my understanding is that the pain associated with Inappropriate Sinus Tachycardia should go away with a reduced heart rate? I wake up in the morning feeling perfectly okay, but then by 4pm I start to go downhill and if i don’t have an epsiode I’m stuck with pinching and sharp chest pains left and right, and pain in my lower ribs. I’ve still been light headed and also experiencing vertigo, the colours I was experiencing with migraines have settled but I keep getting sharp pains in my head…

I was really happy thinking I’d got to the bottom of this but really unsure as to what’s going on.

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u/amsdkdksbbb IST 20h ago

Most of my symptoms (like chest discomfort and shortness of breath) are closely related to the tachycardia. I’ve experienced far fewer episodes, since being on Ivabradine.

I still sometimes experiences palpitations and difficulty in regulating my body temperature, which I associate with just general fatigue of my ANS. This can occur at anytime, and doesn’t seem as closely linked to my heart rate.

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u/sodonewithyourbull 8h ago

Dysautonomia can cause symptoms beyond heart rate and IST is kind of dysautonomia. 

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u/ApprehensiveCry5214 4h ago

I got on Bisoprolol for IST as well, while it pushed my HR down for about a year before it started losing it's effect, I was never symptom free on it. I've had less symptoms on Ivabradine but that one did not control my HR as well. So I'm now on both (my IST is mostly resistant to medication to some degree and sadly until now it ended up stopping to work a few month after beginning that therapy).

I would recommenced to check your blood pressure, because Bisoprolol had me experience all kind of low blood pressure issues. It worked okay on my heart rate but the amount of mg I needed made my blood pressure super low. Feeling light headed and experiencing vertigo is super common in that regard. The fact that beta blockers are mostly blood pressure related is oftentimes the reason why IST patients do change away from it.